The many faces of lung metastases

Shobhana Sivandan
Tuanku Ja’afar Hospital, Seremban, Negeri Sembilan, Malaysia

This lecture explores the wide spectrum of computed tomography (CT) imaging appearances of lung metastases, with a focus on both common and atypical patterns. Typical manifestations include multiple bilateral pulmonary nodules, often randomly distributed, while characteristic features such as cavitation, calcified nodules and miliary micronodules are influenced by the type of primary tumor.

Uncommon presentations are also reviewed, including diffuse infiltrative patterns that may mimic pneumonia, micronodular distributions resembling miliary tuberculosis, and solitary lesions that can be mistaken for primary lung malignancies. The importance of analyzing lesion size, margins, enhancement characteristics, and associated findings is emphasized for accurate interpretation.

The integral role of CT in disease staging, therapeutic response assessment, and long-term follow-up is also highlighted.

Learning Objectives:

• Be proficient in recognizing the varied imaging appearances of pulmonary metastases.
• Apply key imaging features to improve diagnostic accuracy and patient management.